General
HSA and FSA money you didn’t know you could use
Last reviewed July 1, 2026
HSA (Health Savings Account) and FSA (Flexible Spending Account) money is pre-tax dollars you can spend on qualifying medical expenses. Most people use them for copays and glasses. But the eligible expense list is much bigger than that, and it includes a surprising amount of cancer prevention and detection.
The steps
What you can use HSA/FSA for that most people don’t know: genetic testing (BRCA panels via Color, Invitae, etc., often $200-$500 self-pay), skin cancer teledermatology consults, direct-to-consumer PSA and colon screening tests (Cologuard, ColoHealth), copays for diagnostic imaging that isn’t fully covered, SPF sunscreen (yes, it counts if it’s primarily SPF), self-monitoring devices (breast exam trainers, glucose monitors), and travel costs to specialists (mileage, parking, sometimes lodging).
HSA vs FSA: HSA rolls over year to year and is yours to keep. FSA is use-it-or-lose-it, sometimes with a small carryover ($640 in 2026). If you have both options, the "use FSA first at end of year, save HSA for later" strategy makes sense.
The 2026 contribution limits: HSA up to $4,300 individual / $8,550 family (add $1,000 catch-up if 55+). FSA up to $3,300 per year.
This applies when
- You have an HSA or FSA through work
- You have HSA-eligible high-deductible health insurance (allowing you to open an HSA)
- You have expenses that qualify (see IRS Publication 502 for the full list)
This doesn't apply when
- You don't have an HSA or FSA through your employer or a qualified high-deductible plan
- The expense isn't IRS-qualified medical care (see Publication 502)
- You're trying to use leftover FSA funds after leaving your job without a qualifying grace period or carryover
- You want to withdraw HSA funds for non-medical expenses without meeting tax rules
Resources
IRS Publication 502 (medical expense guide): irs.gov/pub/irs-pdf/p502.pdf. This is the source of truth for what qualifies.
HSAstore.com and FSAstore.com: Retail sites that only sell HSA/FSA-eligible products. Useful for confirming eligibility.
Fidelity HSA, Lively, HealthEquity: HSA providers that offer investment options once you have a base balance (usually $1,000+). HSA money can be invested and grown tax-free.
If you're denied
HSA/FSA claims are usually reimbursed by your plan administrator, not your insurance company. If a claim is denied, appeal with documentation showing the expense qualifies under IRS rules (a letter of medical necessity from your doctor helps for anything borderline). Most administrators approve on appeal when documentation is provided.
